Treatment of varicose veins

Varicose veins are a disease accompanied by thinning of the venous wall, an increase in the diameter of the lumen of the veins and the formation of aneurysm-like nodular dilatations. Any vein can be involved, but is more commonly diagnosed in the lower extremities. Treatment of varicose veins includes drug therapy and surgical methods. Lack of therapy increases the risk of dangerous complications.

Causes of varicose veins

The underlying cause of the disease is not fully understood. We can name only provoking factors that increase the risk of developing pathology:

• genetic predisposition. If one of the parents had a disease, then it can develop in children.
• long static loads. Working in a standing position causes stagnation of blood in the veins, which leads to their expansion and causes the development of varicose veins.
• Lack of movement.
• Excessive loads, including professional sports.
• Excess weight, which leads to increased pressure in the vessels of the lower extremities.
• Pregnancy, in which the pressure in the vessels of the small pelvis and lower extremities increases, and the elasticity of the vascular wall also changes.
• Wearing shoes with high heels, which disrupts the contractility of the calf muscle involved in moving blood through the veins (the so-called "muscle pump").
• Improper nutrition (in particular, lack of fiber) leading to constipation, which causes an increase in pressure in the vessels of the small pelvis and lower extremities.
• Bad habits.
• Hormonal imbalances.

These are common causes of dilated veins. If in women the first signs of venous insufficiency appear during pregnancy or immediately after childbirth, then in men, as a rule, the disease makes itself felt after 40 years. The vessels of the legs are more often involved. Treatment of varicose veins of the lower extremities in both sexes is practically the same.

Symptoms of varicose veins of the lower extremities

Officially, the disease is divided into three stages:

1. Compensation.
2. Subcompensation.
3. Decompensation.

In addition, there is an international classification that distinguishes classes:

• C0. There are no signs of vascular damage, but the patient complains of varicose veins.
• C1. Expansion of small superficial veins is noted.
• C2. Expanded veins are revealed during visual examination.
• C3. The patient complains of swelling of tissues, pain, excessive fatigue after a working day.
• C4. The first symptoms of trophic disorders are visually determined.
• C5. Trophic changes appear, but ulcers heal. There may be scarring.
• C6. Trophic changes are pronounced, there are active ulcers.

The degree of pathology is determined on the basis of the results of a visual examination, instrumental diagnostic methods, and existing signs of a chronic disease.

The first symptoms can be called:

• Increased leg fatigue.
• Swelling of tissues, especially pronounced in the evening, passing after a short rest.
• Pain sensations.
• Characteristic heaviness in the legs.
• Nocturnal cramps in calf muscles.
• Burning sensation along the course of the vein.

Pain is especially significant. It never radiates to the thigh or heel, but is always noted at the location of the affected vein and has a aching character. Often the sensations are exhausting, preventing sleep. After sleep, the pain subsides.

At the initial stage, there are no signs of damage to the saphenous vein, but changes are already taking place. The process can take several years, so the treatment of varicose veins often begins when there is already a 3-4 class of pathology. Over time, the clinic increases and the severity of symptoms of venous insufficiency increases:

• Increasing tissue swelling. It is localized mainly in the calf muscles. Like pain, swelling occurs in the afternoon and disappears after a night's rest. It is important to distinguish edema in the calf muscles from swelling of the tissues of the foot. The latter indicates violations of the outflow of lymph.
• Skin itching. It is noted along the vessels.
• Visual changes on the skin in the form of tortuous veins, the presence of extensions.
• Skin changes as a result of circulatory disorders. There is cyanosis, thickening of tissues, darkening is possible.

In the absence of therapy, the clinic is supplemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, and so on. Violation of the venous valves can cause the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, the condition is life-threatening.
• Venous thrombosis. Occurs with blockage of the vessel. It is manifested by severe pain, aggravated during physical activity.
• Pulmonary embolism. Occurs as a result of the separation of a blood clot. With its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcers. The first signs are thickening of the tissues over the affected vein. Further, the tissues become thinner, an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

Diagnosis of the disease

Despite the characteristic symptoms, it is impossible to make a diagnosis and start taking medications based only on the results of a visual examination.

Dopplerography is mandatory. This is one of the easiest ways to assess the vascular bed. It is based on determining the degree of change in the frequency of the sound signal reflected from the blood cells.

When performing ultrasound, angioscanning is performed, which allows assessing the condition of the vessel wall, as well as the direction of blood flow. The result will be a two-dimensional image of the veins with a reflection of the valves, possible blood clots.

In the case when the listed methods do not give an exhaustive answer, CT is prescribed. If thrombosis, angiodysplasia and damage to the veins of the small pelvis are suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins in the legs

A phlebologist is engaged in the diagnosis and treatment of pathology. It is to this specialist that you should contact at the first signs of diseases. In advanced cases, when conservative therapy does not give the desired effect, radical methods are used. In this case, the vascular surgeon is engaged in the elimination of varicose veins.

Methods of treatment are determined based on the results of the examination. In the initial stages, it is possible to use general and local drugs. When the drugs do not work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). Available in the form of tablets and capsules, which have a systemic effect. Thanks to them, it is possible to normalize blood circulation and improve the condition of the whole organism. In addition to tablets, you can use local remedies with a similar effect. These are creams and gels. They have a pronounced effect, but the effect lasts a short time.

The action of phlebotonics is based on improving the elasticity of blood vessels, reducing the permeability of the wall and eliminating congestion. Patients have a decrease in edema and normalization of hematopoiesis.

The use of antiplatelet agents and anticoagulants is allowed. They are indicated at a high risk of blood clots, as well as in their presence. Thanks to them, it is possible to destroy blood clots and reduce viscosity. The funds are used for a pronounced violation of blood viscosity, but with a risk of bleeding, they are not allowed to be used.

In addition to preparations, specialists prescribe compression stockings. It can be elastic bandages, socks, stockings, tights. The positive effect of their use is explained as follows:

• Linen puts pressure on the affected varicose veins and on deep vessels.
• In the lower part of the legs, the vessels experience the most pronounced pressure of knitwear, which eliminates congestion.
• The vessels are constantly in a compressed state, so the operation of the valves becomes more efficient.
• When using underwear, the severity of edema and pain decreases.

Methods of surgical treatment of varicose veins

In the absence of the effect of drug therapy, an operation is prescribed. The indications for its implementation are the following conditions:

• Failure of conservative treatment
• The first signs of thrombophlebitis.
• Pronounced expansion of the vascular wall.
• Significant tissue swelling.

Effective treatment of varicose veins is possible using the following methods:

• Radiofrequency obliteration, which allows you to restore the structure of blood vessels.
• Laser coagulation, during which the affected areas are affected by a laser.
• Varadi technique with complete removal of the affected vessel.
• The Venaseal technique, thanks to which the valves of the veins stick together.
• Sclerotherapy, which allows you to "glue" the vessels from the inside.

Modern methods of treatment of varicose veins allow you to carry out all the necessary procedures without hospitalization and let the patient go home. The choice of technique is determined by the doctor based on the results of the examination.

Prevention of pathology

Varicose veins are difficult to treat, and even after surgery, preventive measures must be taken to prevent recurrence. Some patients use drug therapy all their lives and wear compression stockings. Pathology can be prevented as follows:

• Refusal of dragging things.
• Wearing shoes with a medium heel.
• Complete nutrition.
• Weight control.
• Normalization of the drinking regime.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

Compliance with preventive measures and attentive attitude to the body will help prevent the disease and notice deviations in time. Timely treatment of varicose veins eliminates the progression of pathology and the formation of complications.